Organization
REGIS LEGACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. OLUWASEGUN ISAAC OLUDIRAN (PRESIDENT)
(832) 613-4377
Entity
Organization
Contact information
Practice address
21310 PLUM GATE CT, RICHMOND, TX 77407-1425
(832) 613-4377
Mailing address
21310 PLUM GATE CT, RICHMOND, TX 77407-1425
(832) 613-4377
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
08/15/2024
Last updated
10/14/2024
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